CAJ | 학술논문

目的评价全身MRI对骨转移瘤的诊断价值.方法对30例经病理证实的恶性肿瘤患者在2周内分别进行伞身MRI及核素骨显像(BS),采取临床资料同常规MRI、CT等多种影像资料结合分析,辅以必要的随访复查为"金标准",分别以30例患者和270个部位为单位进行分析.使用McNemar检验比较两者对骨转移瘤诊断的敏感度、特异度.结果 30例患者中,"金标准"诊断27例患者存在骨转移,全身MRI检出25例,2例假阴性,无假阳性患者;BS检出27例阳性患者,其中2例为假阳性.以病例为单位,两者的敏感度均为92.6%(25/27),特异度分别为100%(3/3)及33.3%(1/3).ROC曲线下面积分别为0.9630及0.6296,差异无统计学意义(P>0.05).以病灶部位为单位统计显示全身MRI的敏感度、特异度分别为90.8%(108/119)、98.0%(148/151),高于骨扫描的70.6%(84/119)、90.7%(137/151)(P值均<0.01).全身MRI的ROC曲线下面积为0.9438,大于BS的0.8066(P<0.01).全身MRI同时发现3例患者存在脑转移,4例患者存在肺转移,4例患者存在肝转移.结论全身MRI对骨转移瘤的综合诊断能力较Bs好,具有一定的临床应用价值.
목적 평개전신MRI대골전이류적진단개치.방법 대30례경병리증실적악성종류환자재2주내분별진행산신MRI급핵소골현상(BS),채취림상자료동상규MRI、CT등다충영상자료결합분석,보이필요적수방복사위"금표준",분별이30례환자화270개부위위단위진행분석.사용McNemar검험비교량자대골전이류진단적민감도、특이도.결과 30례환자중,"금표준"진단27례환자존재골전이,전신MRI검출25례,2례가음성,무가양성환자;BS검출27례양성환자,기중2례위가양성.이병례위단위,량자적민감도균위92.6%(25/27),특이도분별위100%(3/3)급33.3%(1/3).ROC곡선하면적분별위0.9630급0.6296,차이무통계학의의(P>0.05).이병조부위위단위통계현시전신MRI적민감도、특이도분별위90.8%(108/119)、98.0%(148/151),고우골소묘적70.6%(84/119)、90.7%(137/151)(P치균<0.01).전신MRI적ROC곡선하면적위0.9438,대우BS적0.8066(P<0.01).전신MRI동시발현3례환자존재뇌전이,4례환자존재폐전이,4례환자존재간전이.결론 전신MRI대골전이류적종합진단능력교Bs호,구유일정적림상응용개치.
Objective The aim of the study was to evaluate the reliability of whole-body MRI(WBMRI)in detecting osseous metastases.Methods Thirty patients verified with malignant tumor by histology were enrolled.All the patients underwent WB-MRI and bone scintigraphy(BS)with a two week interval.Clinical information,conventional MRI and CT images,and follow-up data were collected as gold standard for the diagnosis of bone metastases.The data of 30 patients and 270 segments as study unit respectively were analyzed.The sensitivity and specificity between WB-MRI and BS were compared with McNemar test.Resuits Bone metastases were confirmed in 27 of 30 patients by gold standard.Twenty-five patients with bone metastases were detected by WB-MRI and no false-positive cases.Twenty-seven patients with bone metastases were Nund by BS but having two false-positive oases.With patients as study unit,the diagnostic sensitivity of WB-MRI and BS were both 92.6%(25/27)and the specificity were 100%(3/3)and 33.3%(1/3),respectively.The area under ROC curve of WB-MRI and BS were 0.9630 and 0.6296,respectively(P>0.05).With segments as study unit,119 bone metastases segments were confirmed.The diagnostic sensitivity of WB-MRI and BS were 90.8%(108/119)and 70.6%(84/119)(P<0.01),while the specificity were 98.0%(148/151)and 90.7%(137/151),respectively(P<0.01).The area under ROC curve of WB-MRI and BS were 0.9438 and 0.8066.The former was obviously higher than the latter(P<0.01).Meauwhile.by WB-MRI,3 cases coexisting with brain metastases,4 cases with lung metastases,and 4 cases with hepatic metastases were found.Conclusion WB-MRI was a good tool for screening osseous metastases.